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PubMed1996

Nuclear fragmentation of high-energy heavy-ion beams in water.

As a part of the physical-technical program of the heavy-ion therapy project at GSI we have investigated the nuclear fragmentation of high-energy ion beams delivered by the heavy-ion synchrotron SIS, using water as a tissue-equivalent target. For a direct comparison of fragmentation properties, beams of 10B, 12C, 14N, and 16O were produced simultaneously as secondary beams from a primary 18O beam and separated in flight by magnetic beam analysis. The Z-distributions of beam fragments produced in the water target were measured via energy loss in a large ionisation chamber and a scintillator telescope. From these data we obtained both total and partial charge-changing cross sections. In addition we have performed Bragg measurements using two parallel-plate ionization chambers and a water target of variable length. The detailed shape of the measured Bragg curves and the measured cross sections are in good agreement with model calculations based on semi-empirical formulae.

Boron↗
PubMed1991

Total coronary occlusion: a different animal?

Provided collateralization is adequate, a chronic total coronary occlusion clinically imitates a 90% stenosis but is exempt from the risk of myocardial infarction. For angioplasty of vessels with chronic total coronary occlusion, technical difficulties and clinical risks are balanced against projected subjective benefit and amount of viable myocardium concerned. The primary success rate is approximately 65% and complications are rare because abrupt vessel reclosure may be common but is harmless. New Q wave infarction in that context has not been reported. The duration of occlusion is the most important predictor of success. The length of the occluded segment is also important. Recurrence averages 68% (21% reocclusion and 47% restenosis) and happens typically within 6 months. The high recurrence rate is due to competitive pressure exerted by collateral vessels and an often suboptimal local result. Even if the primary success rate of angioplasty in vessels with chronic total coronary occlusion can be improved by advanced technology and skill, the clinical yield will remain low compared with that of angioplasty of stenoses. Because low yield procedures must be low risk and low cost, there are definite limits to how sophisticated, risky and expensive new techniques can become. Derivatives of conventional balloon systems are likely to remain the equipment of first choice, perhaps complemented by mechanical drills. Although chronic total coronary occlusions are no clinical menace in contrast to stenoses, they frequently deserve revascularization and are the reason to select bypass surgery over angioplasty. These factors justify endeavors to improve recanalization techniques that help to refine coronary angioplasty of nontotal lesions, because total occlusion, albeit a different animal, is of the same species.

Angioplasty, Balloon, Coronary↗
PubMed2003

Medical needs of people with intellectual disability require regular reassessment, and the provision of client- and carer-held reports.

BACKGROUND: Previous work has indicated a wide range of unmet medical health needs in people with intellectual disability (ID). METHODS: A profile of recorded medical needs was produced for 589 people with ID through a detailed search of individual medical and nursing case records. Specialist optometric and audiological assessments were offered, and reports were provided in technical and plain English terms. A Health Watch project delivered folders with copies of the plain English reports to 60 individuals and carers. RESULTS: The case record review indicated a wide range of medical disorders; however, exact diagnoses and counselling regarding underlying neurological conditions were seldom recorded. Assessed levels of hearing and vision loss were much greater than had been previously recognized. The Health Watch reports were welcomed by the clients and carers. CONCLUSIONS: If satisfactory healthcare is to be achieved for people with ID, medical needs must be monitored, regular specialist reassessments offered, access to specialist services facilitated and reports clearly explained to carers.

Adolescent↗
PubMed1999

Video networking of cardiac catheterization laboratories.

BACKGROUND: The purpose of this study was to assess the feasibility and accuracy of a video telecommunication network to transmit coronary images to provide on-line interaction between personnel in a cardiac catheterization laboratory and a remote core laboratory. METHODS: A telecommunication system was installed in the cardiac catheterization laboratory at Kaiser Hospital, Los Angeles, and the core laboratory at the University of California, Irvine, approximately 40 miles away. Cineangiograms, live fluoroscopy, intravascular ultrasound studies and images of the catheterization laboratory were transmitted in real time over a dedicated T1 line at 768 kilobytes/second at 15 frames/second. These cases were performed during a clinical study of angiographic guidance versus intravascular ultrasound (IVUS) guidance of stent deployment. During the cases the core laboratory performed quantitative analysis of the angiograms and ultrasound images. Selected images were then annotated and transmitted back to the catheterization laboratory to facilitate discussion during the procedure. RESULTS: A successful communication hookup was obtained in 39 (98%) of 40 cases. Measurements of angiographic parameters were very close between the original cinefilm and the transmitted images. Quantitative analysis of the ultrasound images showed no significant difference in any of the diameter or cross-sectional area measurements between the original ultrasound tape and the transmitted images. The telecommunication link during the interventional procedures had a significant impact in 23 (58%) of 40 cases affecting the area to be treated, the size of the inflation balloon, recognition of stent underdeployment, or the existence of disease in other areas that was not noted on the original studies. CONCLUSIONS: Current video telecommunication systems provide high-quality images on-line with accurate representation of cineangiograms and intravascular ultrasound images. This system had a significant impact on 58% of the cases in this small clinical trial. Telecommunication networks between hospitals and a central core laboratory may facilitate physician training and improve technical skills and judgement during interventional procedures. This project has implications for how multicenter clinical trials could be operated through telecommunication networks to ensure conformity with the protocol.

Angioplasty, Balloon, Coronary↗
PubMed2004

Rapid assessment procedures in injury control.

Injuries are among the leading causes of death and disability worldwide. The burden caused by injuries is even greater among the poorer nations and is projected to increase. Very often the lack of technical and financial resources, as well as the urgency of the problem, preclude applying sophisticated surveillance and research methods for generating relevant information to develop effective interventions. In these settings, it is necessary to consider more rapid and less costly methods in applying the public health approach to the problem of injury prevention and control. Rapid Assessment Procedures (RAP), developed within the fields of epidemiology, anthropology and health administration, can provide valid information in a manner that is quicker, simpler, and less costly than standard data collection methods. RAP have been applied widely and successfully to infectious and chronic disease issues, but have not been used extensively, if at all, as tools in injury control. This paper describes Rapid Assessment Procedures that (1) are useful for understanding the scope of the problem and for identifying potential risk factors, (2) can assist practitioners in determining intervention priorities, (3) can provide in-depth knowledge about a specific injury-related problem, and (4) can be used in surveillance systems to monitor outcomes. Finally, the paper describes some of the caveats in using RAP.

Data Collection↗
PubMed2002

Health "Smart" home: information technology for patients at home.

This article reviews the emerging concept of health "Smart" homes (HSH) and its potential through the use of telemedical information systems and communication technologies. HSH systems provide health care services for people with special needs who wish to remain independent and living in their own home. The large diversity of needs in a home-based patient population requires complex technology. Meeting these needs technically requires the use of a distributed approach and the combination of many hardware and software techniques. We also describe the wide scope of new information, communication, and data-acquisition technologies used in home health care. We offer an introduction to the HSH concept in terms of technical, economic, and human requirements. Examples of HSH projects are presented, including a short description of our own smart home and telehealthcare information system project.

Aged↗
PubMed2002

Experimental aspects of biological X-ray absorption spectroscopy.

Spectroscopic techniques, like X-ray absorption spectroscopy, will provide important input for integrated biological projects in genomics and proteomics. This contribution summarizes technical requirements and typical set-ups for both simple and complex biological XAS experiments. An overview on different strategies for sample preparation is discussed in detail. Present and future BioXAS spectrometers are presented to help potential users in locating the spectrometer required for their biological application.

Absorptiometry, Photon↗
PubMed1980

Longitudinal study of transpharyngeal radiography in temporomandibular arthropathy.

According to appearance of the condyle on transpharyngeal radiographs temporomandibular arthropathy has a destructive phase and a reparative phase terminating in the stable state of the joint. The destructive phase is characterized by erosion. No common trait of the healing process exists as the healed condyle varies from the normal to the most irregular appearance. Once it occurs, the healing is stable. Ongoing radiologic changes take place within 1-3 years. Some technical considerations including radiation doses of the transpharyngeal projection are presented.

Humans↗
PubMed2003

The relation between education, knowledge and action for better waste management in Poland.

In recent years a significant increase in municipal solid waste (MSW) amount has been noted in Poland, and yet there is no fully efficient system for its treatment. Undertaking projects for rational MSW management requires considering both technical facilities and social barriers (waste reduction, re-use and segregation in households). In Poland, attempts to educate and mobilise society to segregate recyclables have not yet produced satisfactory results. Society's awareness in this field needs to be raised. The purpose of this study was to determine the level of knowledge and understanding about MSW management and the relationship between knowledge possessed and actions undertaken for various residential age groups in two Polish provinces. In all groups, 30% of the respondents showed a satisfactory level of knowledge, whilst an equally small number of individuals had undertaken actions for MSW management at home; people with a higher level of knowledge undertook such actions slightly more often. No significant differences between the provinces were found, but residents of town, where waste segregation has been introduced simultaneously with an information campaign, showed a higher level of knowledge. The study points to the need to further educate people about MSW, and to encourage the teaching of pro-environmental attitudes.

Adolescent↗
PubMed2006

Environmental justice: implications for occupational health nurses.

Through the use of innovative tools, such as clinical mnemonics, exercises in risk and asset mapping, and strategic program development, occupational health nurses can incorporate dimensions of environmental justice (EJ) into the workplace. Occupational health nurses who also take on educational roles can use case studies and network with labor and EJ groups to provide clinical experiences for occupational and environmental health nursing students, thereby integrating EJ into occupational and environmental health nursing practice. Occupational health nurses are well positioned to serve as technical experts within community-based participatory research projects. Occupational health nurses must share their knowledge and experience as members of coalitions that represent workers in their fight for worker health and safety.

Black or African American↗
PubMed2004

European Commission activities in eHealth.

Health-care is an information-intensive and knowledge-demanding sector, which is why eHealth solutions are so important in this field. The European Commission (EC) has been initiating and funding research and development activities regarding Information and Communication Technologies (ICT) for health, or "eHealth", since 1988. These programmes covered priority topics like electronic health-care records, regional and national health networks, telemedicine in homecare and care-at-the-point-of-need to support continuity of care concepts, systems to support people to stay healthy, and systems and tools to support health professionals to work more efficiently and safely on patients. During the 15-year span of the programmes, the European Union (EU) has contributed about 500 million Euro to approximately 400 R&D projects, support activities, best practice and studies covering technical, clinical, ethical, legal, organisational and market issues. eHealth has shown proven benefits in application fields like improved access to care, care at the point-of-need, citizen-centred care, improved quality and cost containment. Such applications were on show at the EU High Level eHealth Conferences in Brussels, Belgium, in 2003, and in Cork, Ireland, in 2004. eHealth is now on the governmental agenda of EU Member States to be implemented on a broader scale. In line with this development, the Commission has taken a number of policy initiatives. A European Union Action Plan for a European eHealth Area was published by the Commission in April 2004 and endorsed by the EU health ministers in June 2004. This means that, for the first time, Europe has a coherent agenda for the implementation of eHealth. This report will concentrate on eHealth activities initiated by the Information Society Directorate-General of the European Commission.

Europe↗
PubMedDate not supplied

European standards and the In Vitro Diagnostic Directive: current status.

The role of harmonized standards to support the proposed In Vitro Diagnostic Directive is examined in this article. EDMA is undertaking a number of activities to aid the standards work. These projects include guidelines on how to construct a technical file and how to conduct risk analysis. These and other initiatives will ensure the active participation of the IVD industry in the formulation of the standards.

Clinical Laboratory Techniques↗
PubMed1978

Economic impact analysis for certificate of need applications.

State certificate of need laws to assess the appropriateness of capital expenditures by health care providers are now mandatory for states which desire federal funds. The cost-effectiveness of proposed projects must be identified. The economic impact analysis outlined here provides for review of the capital and operating costs of and the resource demands made by a proposal. The approach presented provides for a sequential series of increasingly sophisticated analyses required as projects become more complex and use more highly technical resources.

Capital Expenditures↗
PubMed2001

Role of water reuse for enhancing integrated water management in Europe and Mediterranean countries.

Recycling water is an important aspect of water resource and environment management policies, ensuring reliable alternative water resources, reducing environmental pollution and achieving a more sustainable form of development. This paper focuses on wastewater reuse as a strategy for integrated water management. Key economic, financial, regulatory, social and technical factors that help to make water reuse projects successful are reviewed. Selected examples from Northern and Western Europe and arid and semi-arid Mediterranean regions illustrate the contribution of wastewater reuse to integrated management of water resources.

City Planning↗
PubMed2002

IT investment planning: the best hospitals.

A study of hospitals' best practices regarding capital investments in information systems indicates that (1) the process may need more input from IT professionals to cover the technical aspects of planning; (2) the most successful projects are highly aligned with the organization's overall business strategy; and (3) disappointments could be avoided by conducting a better analysis of the organization and its technology, evaluation of past IS performance, and assessment of IS staff capabilities.

Benchmarking↗